A. Nicole La Verne, LPC, MAC, CADC III,

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1853 Issued in OR

Practice address

5285 Meadows Rd Ste 170
Lake Oswego, OR 97035-3478

Phone

(503) 726-5216

NPI assigned

Dec 13, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• A. Nicole Spivey Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sapphire Blue Behavioral Health Solutions

  • Mental Health Counselor
  • Lake Oswego, OR
  • NPI 1558839068
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1083699979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 MEADOWS RD STE 170",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353478",
            "telephone_number": "503-726-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 MEADOWS RD STE 170",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353478",
            "telephone_number": "503-726-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA VERNE",
        "first_name": "A.",
        "middle_name": "NICOLE",
        "credential": "LPC, MAC, CADC III,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "041169U3",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A.",
            "last_name": "SPIVEY",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corinne Andreana Kuszik
• Douglas Richard Kutner, PH.D.
• Vira Kuznyuk, ND
• Katrine Kwiatkowski, PT, DPT
• Caitlin Alice Blum La Motte-Kerr, BCBA
• Alysha Lacey
• Lesley Lacny, MA
• Lanae C Lacourse, LMT
• Lonnamae Margaret Ladke, LCSW
• Monica Ann Lafave

• Professional Counselor in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.